多参数MRI、超声及CT检查在甲状腺腺瘤和甲状腺乳头状癌鉴别诊断中的意义  

The significance of multiparameter magnetic resonance imaging,ultrasound and computed tomography in the differential diagnosis of thyroid adenoma and papillary thyroid carcinoma

作　　者：金耀泉[1] 谢峰[1] 吴平[1] 韩志勇 王鹏 王敬春[1] JIN Yao-quan;XIE Feng;WU Ping;HAN Zhi-yong;WANG Peng;WANG Jing-chun(The Second People's Hospital of Lanzhou,Lanzhou 730046,China)

机构地区：[1]甘肃省兰州市第二人民医院,甘肃兰州730046

出　　处：《中国临床医学影像杂志》2020年第12期867-870,874,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:研究多参数MRI、超声及CT检查在甲状腺腺瘤(Thyroid Adenoma,TA)和甲状腺乳头状癌(Papillary thyroid carcinoma,PTC)鉴别诊断中的意义.方法:收集我院2013年8月—2018年2月经病理学检查确诊的TA及PTC患者各60例作为研究对象,所有患者均进行多参数MRI、超声及CT检查.分别对两组患者的MRI检查结果、DCE-MRI扫描时间-信号强度曲线、CT检查结果及超声检查结果进行比较.结果:PTC组患者的ADC值显著高于TA组,最大强化率(MER)、强化斜率(Slope)显著低于TA组.两组患者的DCE-MRI扫描时间-信号强度曲线之间的差异存在统计学意义(P<0.05),TA组患者主要以Ⅰ型曲线为主,PTC组患者主要以Ⅲ型曲线为主.两组患者CT检查中密度、形态、边缘、钙化情况、囊性变以及动脉期强化情况之间的差异存在统计学意义(P<0.05).两组患者超声检查中边界、形态、声晕、回声、内部结构、钙化情况、纵横比、血流分布情况之间的差异存在统计学意义(P<0.05).多参数MRI对TA组患者的诊断灵敏度显著高于超声、CT检查.结论:通过对多参数MRI量化指标的分析以及超声、CT检查形态学的分析,对于TA及PTC的鉴别诊断具有重要意义.Objective:To assess the significance of multiparameters magnetic resonance imaging(MRI),ultrasound and computed tomography(CT)in the differential diagnosis of thyroid adenoma(TA)and papillary thyroid carcinoma(PTC).Methods:This study enrolled 60 cases of TA and 60 cases of PTC diagnosed by pathology in our hospital from August 2013 to February 2018.All patients were examined by multiparameter MRI,ultrasound and CT.The results of multiparameter MRI,DCE-MRI time signal intensity curve,CT imaging and ultrasound were compared.Results:Apparent diffusion coefficient(ADC)of PTC group was significantly higher than that of TA group,and MER and Slope were significantly lower than that of TA group.There was a significant difference in DCE-MRI time signal intensity curve between the two groups.TA group mainly with type Ⅰ curve,PTC group mainly with type Ⅲ curve.The difference between the two groups with imaging density,shape,edge,calcification,cystic change and arterial phase enhancement was statistically significant(P<0.05);The difference between the two groups with ultrasound results boundary,shape,halo,echo,internal structure,calcification,aspect ratio,blood flow distribution was statistically significant(P<0.05).The sensitivity of multiparameter MRI in the diagnosis of TA was significantly higher than that of ultrasound and CT.Conclusion:It is of great significance for the differentiation of TA and PTC by analyzing the quantitative indexes of multiparameter MRI,and the morphology of ultrasound and CT.

关 键 词：甲状腺肿瘤 磁共振成像 超声检查 体层摄影术 X线计算机 

分 类 号：R736.1[医药卫生—肿瘤] R445.2[医药卫生—临床医学]